A standard dose adrenocorticotropic hormone (ACTH) test (30 μg/kg/dose) revealed an inadequate stimulated cortisol and high 17OHP levels, suggesting simple virilising congenital adrenal hyperplasia (CAH) likely due to 21-hydroxylase deficiency (Table 1). Here, POMC is linked to hyperinsulinemic hypoglycemia, familial, 4.